Implications for practice and research

Implications for nursing practice

▪ Telephone follow-up is more effective at improving glycaemic control if it includes a more interactive element based on the
level of clinical need.

▪ Such models could be important in helping to manage the increasing demand for diabetes care.

Implications for nursing research

▪ Research is needed which will help to determine the added value of the psychological element of the intervention (eg, motivational
interviewing (MI)).

▪ Understanding more about the potential influence of call provider skill and expertise (professional vs non-professional) is
needed to determine the optimum level of training required.

▪ Cost-benefit analysis is recommended.

Context

Diabetes is becoming increasingly common worldwide, representing a huge public health problem. In the UK, diabetes is thought
to affect approximately 2.8 million people overall, and it is estimated that there may be a further 850 000 people with undiagnosed
diabetes. Over 90% of people with diabetes have type 2 diabetes (T2DM), and there are an increasing number of younger adults
with T2DM than previously, with the condition now developing also in children. T2DM is complex in causation and complicated
to manage since it is associated with significant complications affecting the eye, the nervous system and the kidney. There
is a substantial increase in risk of cardiovascular disease and a significant reduction in life expectancy. Achieving optimal
glycaemic control is a key clinical objective in reducing complications, and this relies heavily on patient's adherence to
medical advice on self-care regimes. Patient education programmes incorporating psychological techniques are used to support
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